The Benefit choices you make during your initial enrollment or annual open enrollment remain in effect for the entire year.

EMPLOYEE ELIGIBILITY

• You are eligible to participate if you are full-time and work a minimum of 30 hours per week.
• New hires are eligible for coverage on the first day of the month following 30 days of employment.
• Eligible employees may make their benefit elections during the annual Open Enrollment for a May 1, 2024 effective date. If you do not enroll during this Open Enrollment period, you must wait until the next Open Enrollment period unless you experience a Qualifying Life Event.

DEPENDENT ELIGIBILITY

You may also enroll eligible dependents for benefits coverage. A ‘dependent’ is defined as the legal spouse and/or ‘dependent child(ren)’ of the plan participant or the spouse.

What is a Qualifying Life Event (QLE)?

• Marriage
• Divorce
• Birth/Adoption of a child
• Death of a spouse or other enrolled dependent
• Change in spouse’s benefits or employment status
• A dependent becomes eligible for Medicare or Medicaid

The term ‘child’ refers to any of the following:

• A natural (biological) child
• A stepchild
• A legally adopted child
• A foster child
• A child for whom legal guardianship has been awarded to the participant or the participant’s spouse
• Disabled dependents may be eligible if requirements set by the plan are met.

IMPORTANT

You cannot make changes to these elections during the year unless you experience a qualified family status change, which must be reported to Human Resources within 30 days of the event. You can, however, modify your elections under certain circumstances, called "Qualifying Events" These are events such as marriage, divorce, birth or adoption of a child, loss of eligibility under another plan. If you experience a qualifying event, you may make changes to your benefits within 30 days of the event or 60 days if the event is due to birth or adoption of a child.

If you separate from employment, COBRA continuation of coverage may be available as applicable by law. COBRA Continuation details can be found in the notices section of this employee benefit guide.